Acquired Immunodeficiency
Syndrome (AIDS) is a syndrome that is caused due to the infection of
the Human Immunodeficiency Virus (HIV). HIV affects the body's immune system and lowers the body's
ability to fight off infections. There are different strains of HIV that infect
humans and they are broadly classified into HIV1 and HIV2.

A large number of global efforts focus on controlling the spread of
disease, with the U.N fixing the year 2030 as the "End of AIDS". However, the
numbers continue to rise. "I don't believe the slogan 'The End of AIDS by 2030'
is realistic and it could be counterproductive. It could suggest that it's
fine, it's all over and we can move to something else. No. AIDS is still one of
the biggest killers in the world." said Prof Peter Piot who was the first
executive director of UNAIDS and director of the London School of Hygiene and
Tropical Medicine.

The pessimism revolving around the control of HIV spread is largely due
to inequality in the distribution of medication and the increasing scourge of
drug resistance.

Drug Resistance In HIV

HIV has the ability to mutate and then reproduce with the mutation
intact, leading to failure of anti-retroviral therapy. The limited treatment
options available to treat HIV infection make drug resistance to
anti-retroviral therapy catastrophic. The result is an increase in HIV
incidence, morbidity and mortality.

Advantages of Drug Resistance Testing

Drug resistance to HIV medications affects the number of HIV patients receiving
effective treatment. It is important to have drug resistance testing carried
out to facilitate

More effective
treatment for HIV infection

To ascertain if the individual
was infected with drug resistance strain at the onset of infection or during
the course of treatment.

To monitor progress of the
treatment procedure.

Existing Sequencing Test for HIV Drug Resistance

Most of the genomic sequencing kits that are available are now outdated
and are no longer in use. The only test still in existence has the following
disadvantages

It uses the Sanger's
method of sequencing which is now replaced by better methods.

Drug resistance that occurs at a frequency below 15-20% cannot
be detected.

The results take a long time, about one to two
weeks.

First Next Generation Sequencing Test for Drug Resistance In HIV

Dr. Gerd Michel and colleagues from Vela Diagnostics in Singapore have
created a next generation genome sequencing kit to detect HIV resistance. The
new test 'Sentosa SQ HIV-1 genotyping assay' offers hope to a future of better
drug resistance testing.

This new-age testing offers an integration between automatic sample
processing as well as analysis of the data obtained using a software.

The efficiency of Sentosa SQ HIV-1 genotyping assay was compared with
that of TruGene HIV-1 genotyping kit which is based on the Sanger's method of
genome sequencing. The viruses' protease gene and the reverse transcriptase
gene were analyzed from 111 blood sample of HIV-1 positive patients.

Dr. Michel added "To our knowledge, nobody else has developed an assay
like this. Now we have the opportunity to do HIV drug resistance testing much
faster, at a lower cost, and also to test for mutations that are not visible
with Sanger sequencing. The impact of these mutations that have not been seen
by Sanger is not known yet. But now we have the tools to detect them so that
researchers can determine how relevant they are clinically and physicians can
determine if there should be a change in treatment."

Results of the Comparison Study

Sentosa SQ HIV-1
test found 100% mutations in all virus protease genes when compared with 90.45%
detected by TruGene HIV-1.

Sentosa SQ
HIV-1 test detected drug resistance in the HIV Integrase gene that is not
detected by TruGene. The HIV Integrase gene shows high incidence of developing
drug resistance through mutations in the U.S population.

Sentosa SQ HIV-1 test provides results withing two and a
half days, which is a lot faster than TruGene test.

Vela Diagnostics plans to bring out this innovative test for drug
resistance testing soon, raising hopes for better control and treatment of HIV.

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